Uro Cancer

Question 1

___% of bladder cancer is invasive at presentation

Answer 1

25% (deadly too, 50% dead in 2 years)

Question 2

superficial bladder cancers are costly because?

Answer 2

they recur frequently, and thus require costly monitoring

Question 3

who is most likely to get bladder cancer?

Answer 3

in the US, white males (but in Med/N Africa all has to do with who gets schisto)

Question 4

cytoscopic appearance of bladder cancer

Answer 4

prondular or broccoli-like

Question 5

invasive bladder cancer is associated with chromosome ____ abnormalities, while superficial is assoc with chromosome ____

Answer 5

17; 9

Question 6

symptoms of bladder cancer

Answer 6

hematuria + irritative voiding sx

Question 7

diagnosis of bladder cancer

Answer 7

cystoscopy (through urethra), urine cytology, CT urogram, TURBT

Question 8

tx of superficial bladder cancer

Answer 8

TURBT +/- intravesicular therapy

Question 9

tx of muscle-invasive bladder cancer

Answer 9

cystectomy + urinary diversion (chemo before may improve survival)

Question 10

dx of upper tract urothelial carcinoma

Answer 10

CT urogram, cytology, ureteroscopy

Question 11

tx of upper tract urothelial carcinoma

Answer 11

nephrourectomy if high grade, partial ureterectomy or laser ablation if low grade and distal

Question 12

what type of cancer is renal cell?

Answer 12

adenocarcinoma arising from proximal tubule

Question 13

all types of RCC are associated with loss of control of?

Answer 13

angiogenesis pathways

Question 14

non-carcinogenic renal tumors

Answer 14

angiomiolipoma, oncocytoma, complex renal cysts

Question 15

diagnosis of RCC

Answer 15

CT scan with or without contrast shows heterogeneous, enhancing mass

Question 16

tx of RCC

Answer 16

T1-T3 = partial nephrectomy (unless super large); T4,N+,M+ = anti-VEGF, IL2 tx, +/- nephrectomy

Question 17

tx of small renal masses

Answer 17

partial nephrectomy, ablation, surveillance

Question 18

most common solid tumor of young adult men

Answer 18

testicular carcinoma

Question 19

radiation works well to treat this type of testicular cancer

Answer 19

seminomas

Question 20

testicular cancer grows (slowly/quickly) and metastasizes to the ______ LN

Answer 20

quickly; retroperitoneal

Question 21

detection of AFP definitively rules out?

Answer 21

seminomas

Question 22

4 signs of testicular cancer

Answer 22

painless testicular mass, secondary hydrocele, retroperitoneal mass, hormonal effects (rare)

Question 23

tx of testicular cancer

Answer 23

radical orchiectomy (ALWAYS) through inguinal incision +/- LN dissection, radiation (seminoma), chemo (platinum-based is curative)

Question 24

side effects of surviving testicular cancer

Answer 24

infertility, retrograde ejaculation, cosmetic issues, metabolic issues from chemo

Question 25

penile cancer is related to?

Answer 25

chronic inflammation from hygienic issues, foreskin, infections (like HPV)

Question 26

penile cancer spreads to the ____ LN

Answer 26

inguinal

Question 27

tx of penile cancer

Answer 27

ABX to r/o infectious cause of enlarged LNs, partial or complete penectomy, +/- inguinal LN dissection, radiation/CTX for advanced cases with limited efficacy

Question 28

penile cancer prognosis

Answer 28

80% with localized cancer survive; 30% if LNs involved; 5% if metastatic